An important first step is to find a doctor that you feel like you can talk to. According to the AAP, in the book Caring For Your Baby and Young Child: Birth to Age 5, "different Pediatricians have different approaches, so you may want to interview several candidates before selecting the Pediatrician who best suits your family's particular preferences and needs."
Once you have picked a Pediatrician, an easy way to maximize your time with the doctor is to learn how to communicate more effectively and be able to tell your Pediatrician what is wrong with your child. There is nothing more frustrating that seeing a patient, asking what is wrong or why they came to the doctor, and getting a very vague answer, such as 'he is sick'. The doctor then has to spend a large part of the visit just asking general questions to figure out what your child's symptoms are.
In medical school, doctors learn how to 'present' their patients as they tell more senior doctors what is wrong with the patient. This usually begins with a chief complaint, or the main reason that you came to the doctor, such as my 'child has a fever ' or 'he has a bad cough.' The chief complaint is followed by the 'history of present illness,' which includes what other symptoms he has, when they began, and what makes the symptoms better or worse.
If you learn to 'present' your child to your Pediatrician at the beginning of the visit, then that will leave more time for your doctor to ask some followup questions, examine your child, and then discuss what is wrong and what the treatment should be.
An example of how to 'present' a typical school age child with a cold or upper respiratory tract infection, which is turning into an ear infection, might include:
His main problem is that he was up all night complaining that his left ear hurt (so his chief complaint is ear pain). He was fine until about four days ago, when he began to have a clear runny nose, an occasional cough, and a low grade fever. He was eating and drinking well and had been in a good mood until last night, when he developed a fever and began to complain that his left ear hurt. The pain was better after I gave him some ibuprofen, but he woke up twice complaining that his ear was hurting, although it doesn't hurt if I touched the outer part of his ear. He has had no vomiting or diarrhea, and his best friend was sick with a cold last week. He is taking ibuprofen and a cold and cough medicine, although it isn't helping very much.After hearing this story, most Pediatricians would have a good idea of what's wrong, and will have more time for the physical exam and to discuss the final diagnosis and treatment plan. If you had just said that his ear hurts, then your doctor would have to ask questions trying to narrow down the diagnosis. Is it a middle ear infection or an outer ear infection (swimmer's ear)? By just hearing a complaint of ear pain, your doctor wouldn't know and would have to ask about cold symptoms, if he has been swimming, if the pain is worse if you tug on his outer ear, etc.
Or a child with a sinus infection might present as:
having a green runny nose (chief complaint), which started as a clear runny nose two weeks ago, and then worsened this past week. He also now has a worsening cough, that is productive of green sputum (or you can say 'green gunk' to be less medical), decreased appetite, and he developed a fever last night. He has no vomiting or diarrhea or difficulty breathing and hasn't been around anyone that is sick, although he is in day care.Although a cold can sometimes cause a green runny nose for up to two weeks, the fact that his symptoms are worsening and now include a fever, would make your Pediatrician think of a sinus infection.
For a child with a stomach virus, your presentation might be like this:
He started to have vomiting and diarrhea last night. He is vomiting everything he tries to eat or drink, and has already had diarrhea 7 times this morning. The last time he urinated was last night and his mouth seems dry. He has had a low grade fever, but no stomach pain. Also, there is no blood or mucus in his diarrhea and half of his class at school has had the same symptoms.This story would quickly help your Pediatrician that your child likely has an acute gastroenteritis, likely caused by a virus, and that he is dehydrated.
